Please complete your order by filling in the below order form. Your order will be forwarded to your preferred wholesaler. Order form Vet Practice Name* Responsible person* Email address* Preferred Wholesaler*NorpharmLakato JHBLakato (CPT)Lakato (KZN)Lakato (PE)AlphapharmTranspharm CTTranspharm PretoriaTranspharm KZNVetserv PEVetserv CPTVetserv ELMVW GatuengMCPMidlands Veterinary Wholesaler (KZN)Midlans Veterinary Wholesaler (George)PharmedLionels Vet (CPT)Biofarm (CPT)Biofarm (Kroonstad)UPD (JHB)UPD (Bloemfontein)UPD (Durban)UPD (PE)OtherIf other please specify* Order DetailsProduct Rimifen 20mg Quantity Product Rimifen 100mg Quantity NameThis field is for validation purposes and should be left unchanged. Δ
